Food-borne trematodiasis: current chemotherapy and advances with artemisinins and synthetic trioxolanes

Over 40 million people are infected with food-borne trematodes and 750 million are at risk of food-borne trematodiasis, and yet this tropical disease is neglected. The current arsenal for the treatment and control of food-borne trematodiasis comprises praziquantel and triclabendazole, which were developed 20-30 years ago. The safety, therapeutic profiles and concern about resistance of these two drugs are summarized here. Recent advances with the artemisinins, which are best known for their antimalarial and antischistosomal properties, and the synthetic trioxolanes in different trematode-rodent models are reviewed. Lastly, prospects for the development of a safe, efficacious, inexpensive and broad-spectrum trematocidal drug are considered.